Description

Etoposide 50 mg capsules are a medication used to treat various types of cancer, including small cell lung cancer, testicular cancer, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, acute myeloid leukemia, and ovarian cancer.

Indications

Etoposide 50 mg capsules are used to treat various types of cancer, including:

• Small cell lung cancer
• Testicular cancer
• Hodgkin’s lymphoma
• Non-Hodgkin’s lymphoma
• Acute myeloid leukemia
• Ovarian cancer

Pharmacokinetics

• Oral bioavailability: around 50% compared to intravenous administration

Side Effects

Common side effects include:

• Myelosuppression
• Liver/kidney impairment
• Gastrointestinal symptoms

Clinical Use

• Maintenance therapy with etoposide capsules has been shown to improve progression-free survival in some small cell lung cancer patients
  

  Key Benefits

  Indications

  • Etoposide 50 mg capsules are used to treat various types of cancer, including:
    • Small cell lung cancer
    • Testicular cancer
    • Hodgkin’s lymphoma
    • Non-Hodgkin’s lymphoma
    • Acute myeloid leukemia
    • Ovarian cancer

  Dosing and Administration

  • The usual oral dose of etoposide is 100-200 mg/m2/day on days 1-5 or 200 mg/m2/day on days 1, 3 and 5 every 3-4 weeks
  • Oral bioavailability is around 50% compared to intravenous administration
  • Maintenance therapy with etoposide capsules has been shown to improve progression-free survival in some small cell lung cancer patients

  Key Ingredients

  Active Ingredient

  • Each capsule contains 50 mg of the active ingredient etoposide

  Excipients

  • Each 50 mg capsule contains:
    • 0.93 mg of sodium ethyl parahydroxybenzoate (E215)
    • 0.47 mg of sodium propyl parahydroxybenzoate (E217)

  The capsule shell is an opaque pink soft capsule.                                                                                     key points that make etoposide 50 mg capsules effective for treating various cancers:

  Mechanism of Action

  • Etoposide is a cell-cycle specific drug that works by inhibiting the enzyme topoisomerase II, which is involved in DNA replication and cell division .
  • This mechanism of action allows etoposide to slow the growth of cancer cells.

  Pharmacokinetics

  • Oral etoposide capsules have around 50% bioavailability compared to intravenous administration, allowing for effective systemic exposure .
  • Maintaining etoposide concentrations between 0.5-1.0 mg/mL in the plasma for several hours has been shown to maximize the anti-tumor effects .

  Clinical Efficacy

  • Etoposide capsules have demonstrated efficacy in treating various cancers, including:
    • Small cell lung cancer 
    • Testicular cancer 
    • Hodgkin’s lymphoma 
    • Non-Hodgkin’s lymphoma 
    • Acute myeloid leukemia 
    • Ovarian cancer 
  • Maintenance therapy with etoposide capsules has been shown to improve progression-free survival in some small cell lung cancer patients .

  Safety Profile

  • Common side effects include myelosuppression, liver/kidney impairment, and gastrointestinal symptoms, which are generally manageable with supportive care .
  

  Etoposide

  Chemotherapy medication

  More

  Used for

  Treatment of various cancers such as testicular cancer, lung cancer, lymphoma, leukemia, neuroblastoma, ovarian cancer, and hemophagocytic lymphohistiocytosis

  Administration

  Oral or intravenous injection

  Common side effects

  Low blood cell counts, vomiting, loss of appetite, diarrhea, hair loss, fever
  Based on the search results, here is an explanation of the mechanism of action of etoposide:

  Mechanism of Action

  Etoposide exerts its antineoplastic effects primarily by inhibiting the enzyme topoisomerase II (TOPOII). Topoisomerase II is an enzyme that plays a crucial role in regulating the topological state of DNA by introducing transient breaks in the DNA molecule. This enzyme is involved in fundamental cellular processes such as DNA replication, transcription, and repair.The key steps in etoposide’s mechanism of action are:

  1. Etoposide forms a ternary complex with DNA and the topoisomerase II enzyme.
  2. This binding prevents topoisomerase II from re-ligating the DNA strands after it has created a double-strand break to relieve DNA supercoiling.
  3. The persistent DNA breaks caused by the inability of topoisomerase II to re-ligate the strands leads to errors in DNA synthesis and ultimately promotes apoptosis of the cancer cell.

  The isoenzyme topoisomerase II-alpha (TOP2A) is particularly overexpressed in tumor cells and is the primary target of etoposide’s cytotoxic effects. Inhibition of this enzyme is the main mechanism by which etoposide exerts its anti-cancer activity.

  

  Precautions

  Monitoring

  • Periodic complete blood counts should be done during the course of etoposide treatment, prior to each cycle and at appropriate intervals.
  • Renal function should also be monitored, especially in patients with impaired renal function.

  Dose Adjustments

  • The dose of etoposide should be modified based on the myelosuppressive effects of other drugs in the combination regimen or the effects of prior radiation/chemotherapy.
  • For patients with impaired renal function (creatinine clearance 15-50 mL/min), the initial dose should be reduced to 75% of the normal dose.

  Handling and Administration

  • Etoposide capsules should be taken on an empty stomach.
  • Proper handling and disposal procedures for cytotoxic drugs should be followed.
  • Etoposide capsules must be stored under refrigeration between 2-8°C.

  Contraindications and Interactions

  • Etoposide is contraindicated in patients with hypersensitivity to the active substance or excipients.
  • Concomitant use of yellow fever vaccine or other live vaccines is contraindicated in immunosuppressed patients.
  • High-dose cyclosporine A can increase etoposide exposure by 80%.

  Other Precautions

  • Etoposide should only be administered and monitored under the supervision of an experienced oncologist.
  • Patients with low serum albumin may be at increased risk of etoposide-associated toxicities.
  • Etoposide is pregnancy category D and should not be used in nursing mothers.

  Drug Interactions

  • Etoposide can interact with other drugs, potentially increasing or decreasing its effects. Some notable interactions include:
  • Acenocoumarol: The therapeutic efficacy of acenocoumarol can be increased when used in combination with etoposide.
  • Abametapir: Can increase serum concentrations of etoposide.
  • Abatacept: May increase the metabolism of etoposide.
  • Abciximab: Increases the risk or severity of bleeding when combined with etoposide.
  • Abemaciclib: May decrease the excretion of etoposide, leading to higher serum levels.
  • Abiraterone: Can increase serum concentrations of etoposide.

  Food Interactions

  • Avoid grapefruit products, as they inhibit CYP3A4 metabolism and may increase etoposide serum levels.
  • Exercise caution with St. John’s Wort, as it induces CYP3A4 metabolism and may reduce etoposide serum levels.

  Contraindications

  • Concomitant use of yellow fever vaccine or other live vaccines is contraindicated in immunosuppressed patients taking etoposide.

  Monitoring

  • Periodic complete blood counts and renal function tests should be done during etoposide treatment, especially in patients with impaired renal function.
  • The dose of etoposide may need to be modified based on the myelosuppressive effects of other drugs in the combination regimen or the effects of prior radiation/chemotherapy.

  Dietary Restrictions

  Timing of Administration

  • Etoposide capsules should be taken on an empty stomach. They should be taken at least 1 hour before or 2 hours after a meal.

  Grapefruit Products

  • Patients should avoid grapefruit products, as they can inhibit the CYP3A4 metabolism of etoposide, leading to increased serum levels of the drug.

  St. John’s Wort

  • Caution is advised with concomitant use of St. John’s Wort, as it can induce CYP3A4 and potentially decrease etoposide serum concentrations.

  Other Dietary Considerations

  • There are no other specific dietary restrictions mentioned in the search results. However, as with any chemotherapy medication, it is generally recommended that patients maintain a well-balanced, nutritious diet to support their overall health during treatment.

  Dosage

  • The usual oral dose of etoposide is 100-200 mg/m2/day on days 1-5 or 200 mg/m2/day on days 1, 3 and 5 every 3-4 weeks, either as monotherapy or in combination with other chemotherapeutic agents.
  • In small cell lung cancer specifically, the recommended oral dose is two times the IV dose rounded to the nearest 50 mg.
  • The dose should be modified based on myelosuppressive effects of other drugs, prior radiation/chemotherapy, and renal function.

  Storage

  • Etoposide 50 mg capsules must be stored under refrigeration between 2-8°C (36-46°F).
  • The capsules are stable for 36 months under refrigeration.

  Reviews

  • No specific reviews were provided in the search results.
  • However, etoposide is an established chemotherapy medication with demonstrated efficacy in treating various cancers.
  • As with any chemotherapy, close monitoring for side effects is important. Common side effects include myelosuppression, liver/kidney impairment, and gastrointestinal symptoms.

  Handling Precautions

  Gloves

  • Always wear impervious gloves when handling the blister packs containing the etoposide capsules. This prevents exposure to the medication.

  Spills and Leaks

  • If any etoposide capsules leak from the blister pack, do not open the pack. Dispose of the entire pack properly.
  • If etoposide contacts the skin, mucosa, or eyes, immediately wash the affected area with soap and water.

  Disposal

  • Procedures for proper handling and disposal of anticancer drugs should be followed.
  • Any unused or expired etoposide capsules should be disposed of in accordance with local requirements, not flushed down the toilet or poured down a drain.

  Storage

  • Etoposide capsules must be stored under refrigeration between 2-8°C (36-46°F).
  • Do not freeze the capsules.
  • Keep all medications out of the reach of children.